Taking innovative cancer treatments to emerging markets

The growing importance of health insurances

As the world confronts an “epidemic of cancer” in the wake of the pandemic, widening access to cancer care - from screening, diagnosis, and innovative treatments to follow-ups - is a priority for healthcare providers around the world. Cancer claimed almost 10 million lives in 2020, and the impact of the pandemic on screening, detection and treatment is likely to increase that number in 2021 and beyond.

The problem is particularly acute for developing economies with limited resources, where the UN Sustainable Development Goal of universal health coverage by 2030 has not been achieved. And the challenge is exacerbated by the rapid emergence of immuno-oncology (IO) therapies. These have the potential to transform cancer outcomes, but some public providers face affordability issues around funding.

It is here that private health insurance could be an important funding mechanism. It can help to expand provision and protect more patients from catastrophic out-of-pocket spending if they fall sick. So what are the lessons from innovative insurance programmes around the world that are increasing access to IO therapies – and what barriers are still stopping countries from expanding uptake?

How insurance can increase access to innovative treatments

As innovative IO therapies become available, health providers across both public and private spheres are exploring ways to broaden access to treatment in developing markets.

In Indonesia, cancer is the second biggest disease in terms of health expenditure. Fully funding IO therapies will be difficult, says Professor Aru Sudoyo, Chairman of the Indonesian Cancer Foundation, but insurance can expand access for some customers while state provision is being ramped up.

“Private insurance has been giving more and more patients access to treatment in the past few years,” he says. “And it will be critical in the future – I see no other way forward.” According to Professor Sudoyo, policymakers could quickly expand provision by allowing insurance payments to top up core, publicly funded provision – something that is currently prohibited.

Elsewhere, policymakers are using different approaches to expand access to care and address health inequalities. Under the Dubai Health Authority’s Basmah initiative, Dubai’s blue-collar expatriate population gains comprehensive coverage for breast, colorectal and cervical cancer from screening to treatment.

What is private health insurance up against?

While innovative new models are expanding support for cancer treatment, insurance industry figures believe that uptake can be expanded significantly – especially if providers can address consumers’ perceptions and misconceptions about health insurance.

For the industry, the first step is to simplify its offer to consumers, says Veronica Scotti, Chairperson of Public Sector Solutions at re-insurer Swiss Re.

“One of the biggest barriers is people’s anxiety about entering into an insurance contract,” she says, especially in countries with extensive informal markets and low levels of financial and legal literacy. Complicated provisions and long-term obligations can be off-putting if not explained clearly. “People need to be able to read and understand the terms of the contract,” says Scotti.

“One of the biggest barriers is people’s anxiety about entering into an insurance contract. People need to be able to read and understand the terms of the contract.”

Veronica Scotti,

Chairperson of Public Sector Solutions, Swiss Re

In South Africa, private healthcare is largely funded by individuals who opt in to medical aid schemes, which reimburse the cost of care for defined conditions. On the majority of entry- and mid-level options, complex exclusions exist on innovative cancer treatments such as Targeted Therapy – something that many cancer patients only realise after a diagnosis.

Closing the cancer care provision gap that exists in the medical aid space was what motivated PPS to launch the innovative EXACT Rider, an optional benefit on its Critical Illness Cover, a life insurance product which is reinsured by Hannover Re. Its ground-breaking approach to funding cancer treatment uses genomic testing to identify patients suitable for Targeted Therapies, which unlocks additional lump-sum benefit payouts.

The cost of insurance is inevitably a consideration, but it has to be weighed against the cost of treatment, says Soeren Kruse, Head of Business Acquisition & Development for Hannover Re in South Africa. “A lot of people underestimate the true cost of cancer treatment,” he says. “Thus, most people have a protection gap they are not always aware of.”

“A lot of people underestimate the true cost of cancer treatment. Thus, most people have a protection gap they are not always aware of.”

Soeren Kruse,

Head of Business Acquisition & Development, Hannover Re, South Africa

People are thinking more about their health

Demand for IO therapies will rise as more treatments pass clinical trials and become available to healthcare providers around the world. However, making them available to individuals is more difficult. Could private healthcare insurers step in here to increase access while public provision ramps up?

Soeren Kruse says there is evidence that Covid-19 is prompting people to think more carefully about their potential health and life insurance needs. “We are already noticing an increased awareness amongst policyholders about the importance of their protection. This leads to improved persistency in our life insurance books,” he says. This increased awareness could be an opportunity for the insurers that simplify their products and communications to appeal to more people and support the rollout of innovative cancer treatments.